ess deeply.

[beta]. The clinical differences. Normoblasts are found almost
invariably in all severe anaemias that are the result of trauma,
inanition or organic disease of some kind. They are however mostly
rather scanty, so that a preparation must be searched for some time
before an example is found. But occasionally, most often in acute, but
also in chronic anaemias, and even in =cachectic= conditions, every field
shews one or more normoblasts.

V. Noorden was the first to describe a case in which in the course of a
haemorrhagic anaemia normoblasts temporarily appeared in such overwhelming
numbers in the circulating blood, that the microscopic picture, which at
the same time comprised a marked hyperleucocytosis, was almost similar
to that of a myelogenous leukaemia. And as in addition to this occurrence
the number of blood corpuscles was nearly doubled, v. Noorden gave it
the distinctive name "blood crisis."

The following procedure is to be recommended for the
investigation of the blood crisis:

1. Estimation of the absolute number of red blood corpuscles.

2. Estimation of the proportion of white to red corpuscles.

3. Estimation of the proportion of nucleated red to white
corpuscles by means of the quadratic ocular diaphragm (see page
31) in the dry preparation.

For instance if we find in a case of anaemia, 3-1/2 millions of
red blood corpuscles, the proportion of white to red corpuscles
= 1/100 and that of the nucleated red to the white = 1/10, then
in 1 cubic millimeter there are 3500 nucleated red corpuscles,
that is for 1000 ordinary there is 1 nucleated corpuscle.

=Megaloblasts= on the contrary are never found in traumatic anaemias. And
in chronic anaemias of the severest degree, the result for example of old
syphilis, carcinoma of the stomach and so forth, one looks for them
almost always in vain, although they are sometimes to be found in
leukaemia. On the contrary, the conditions, apparently much milder, in
which from the clinical history, aetiology and general objective symptoms
pernicious anaemia is suggested, are almost without exception
characterised by the appearance of megaloblasts in the blood.
Nevertheless in very late stages of the disease they are always scanty,
and a very tedious search through one or more specimens is often
required to demonstrate their presence. Hence follows the rule, that the
investigation of a case of se